Probiotics for Prevention of Antibiotic-Associated Diarrhoea in Children: A Systematic Review

Diarrhoea is one of the commonest adverse effects of antibiotic treatment in childhood, and probiotics are widely used to prevent it. This review summarises published randomised trials, meta-analyses, guidelines and safety reports on probiotics for the prevention of antibiotic-associated diarrhoea in children, and it reports no new data. Pooled analyses suggest that selected strains, mainly Lactobacillus rhamnosus GG and Saccharomyces boulardii at adequate doses, lower the risk of diarrhoea roughly by half, whereas other strains and products have not shown benefit. Evidence for preventing Clostridioides difficile infection in children is weaker. Strain specificity, variable definitions of diarrhoea, small trials and sparse safety data in vulnerable children limit the strength of recommendations.